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Biomedical subjects

E H Farthmann

Publications and source records attributed to E H Farthmann.

At least 127 records · Page 7Linked to original sources
PubMed1989

[The pathomorphology of the liver after unilateral hepatic duct obstruction with laboratory-chemical observations of the course in the dog].

UNLABELLED: In an experimental study the morphological and functional changes of the liver with unilateral hepatic duct obstruction were investigated over a period of 13 months. In 4 series different parts of the liver were excluded of the bile drainage by hepatic duct ligation after cholecystectomy (group I = 25%, group II = 50%, group III 75%, group IV = 100% of the liver, series V = control group was cholecystectomy only. The clinical outcome, biochemical parameters, liver biopsy were examined regularly. Bacteriologic investigation of the bile and hepatic flow measurement were performed at the beginning and at the end of the study. RESULTS: The clinical symptoms were discrete and the biochemical parameters showed a typical course. After 6 weeks, atrophy of the excluded liver with contralateral compensatoric hypertrophy was found. The microscopic correlation was the secondary sclerosing cholangitis (SSC). After 6 weeks, a concentric periductal fibrosis was to be observed in the periportal area. After 12 weeks, bile duct vanishing with persistence of the arteries and veins was found. After 36-48 weeks, biliary cirrhosis and total destruction of the liver parenchyma was found respectively. Simultaneously a chronic disturbance of the hepatic perfusion was seen. It was caused by a perivenous fibrosis of the terminal vein with obliteration of the lumen by endangiitic proliferations and cavernous transformation. The genesis of SSC seemed not be be influenced by bile contamination. The ligated as well as the unligated bile ducts were infected in 20-50% only. There was no difference in the liver specimens with sterile or contaminated bile. The hepatic flow measurement showed a reduction of the portal blood flow and a rise of the arterial flow depending on the amount of the excluded liver. A better understanding of the pathophysiological sequelae of the unilateral hepatic duct obstruction suggests that the drainage by surgical or radiological methods may not invariably be necessary.

Animals↗
PubMed1988

Endoscopic percutaneous cecostomy (EPC).

Endoscopic decompression of the distended colon has become a useful method of treating non-obstructive colonic ileus. We propose a method of establishing a cecal fistula by means of percutaneous puncture of the colon and pull-through of a Pezzer catheter. Although until now we have only performed this procedure twice, it seems to be a valuable therapeutic approach in cases of paralytic distension of the large bowel.

Aged↗
PubMed1987

Continuous-plus-on-demand epidural infusion of buprenorphine versus morphine in postoperative treatment of pain. Postoperative epidural infusion of buprenorphine.

In a randomized, double-blind study, buprenorphine was compared with morphine in the treatment of pain after major abdominal operations by means of continuous-plus-on-demand epidural infusion for constant analgesia. The patients received bolus epidural injections of 0.15 mg buprenorphine or 2 mg morphine-HCl prior to an on-demand epidural infusion of 0.03% buprenorphine or 0.25% morphine HCl at a basal rate of 0.06 ml/h. Over 50 h, mean buprenorphine consumption was 0.85 +/- 0.08 mg, and mean morphine consumption was 6.4 +/- 0.5 mg. Under the treatment, no discomfort or side-effects necessitating treatment occurred. We conclude that buprenorphine is a useful substitute for morphine in the treatment of pain after major abdominal operations by continuous-plus-on-demand epidural infusion, and that the relative analgesic potency ratio of epidural buprenorphine is 8.

Adolescent↗
PubMed1987

[Aspects of splenic surgery].

OPSI (overwhelming postsplenectomy infection) after traumatic or accidental splenectomy is a very rare but mostly deleterious complication. Conservation of the spleen is preferable to autologous transplantation into the greater omentum. The results at this moment are not clear and emphasize the need for further research.

Humans↗
PubMed1987

[Cancer of the middle third of the rectum].

Anterior resection and abdominoperineal resection are standard procedures to treat cancer in the upper and the lower third of the rectum, respectively. The area of interest today is the middle third of the rectum, i.e. the part 7.5-12 cm above the anal verge. Surgical therapy is mainly based on prognostic tumor factors and preoperative staging. The degree of tumor infiltration of the rectal wall and the number of positive lymph nodes are of paramount importance. For preoperative staging the results of digital examination are improved by new imaging techniques. Endorectal ultrasound is able to oklineate tumor infiltration of the rectal wall, whereas computed tomography is better suited to identify tumor infiltration outside the rectum. Preoperative lymph node staging is still not reliable. The surgeon, therefore, has to decide on the surgical therapy intraoperatively. Local tumor excision is possible only if the tumor can be reached by the finger of the surgeon, i.e. if located not more than 10 cm above the anal verge. Local excision is an acceptable procedure in high grade cancers of less than 3 cm diameter and infiltration of the muscularis propria, preferably submucosa only. Further studies are needed to evaluate the long term results. Adjuvant preoperative radiation therapy is applied increasingly in tumors infiltrating beyond the rectal wall. There is at present no apparent benefit from chemotherapy for carcinoma of the rectum.

Combined Modality Therapy↗
PubMed1986

[Gallstone ileus--a diagnostic and indications problem--report on 35 patients].

The clinical data of 35 patients with gallstone ileus treated between 1970 and 1984 at the Department of Surgery of the University Hospital of Freiburg were retrospectively analysed with respect to duration of symptoms prior to surgery, preoperative diagnostic, operative procedure and outcome. No reliable test could be found that will lead the clinician to the correct diagnosis in most cases. The classical sign of gallstone ileus--small bowel obstruction combined with pneumobilia in the plain abdominal X-ray--was apparent only in 20%. So, a high index of suspicion, especially in old female patients with small bowel obstruction and prompt surgical intervention will decrease mortality. Enterotomy with removal of the stone without simultaneous cholecystectomy can be recommended as a safe procedure even in very old patients.

Abdomen, Acute↗
PubMed1986

Diagnostic procedures leading to successful separation of xipho-omphalopagus twins.

Xipho-omphalopagus twins with a pericardial bridge, extended liver tissue union and considerable intestinal herniation from one abdominal cavity to the other were separated successfully at the age of three months. Special diagnostic procedures including cardiac and abdominal sonography, catheterism of the umbilical vein with portal angiography, radionucleotide liver and bile duct imaging and separate oral glucose tolerance tests provided important information for perioperative and surgical patient management. Relevant items for determination of the favourable data and method of surgery are discussed.

Adolescent↗
PubMed1985

Relapsing pancreatitis associated with duodenal wall cysts. Diagnostic approach and treatment.

A case of enterogenous cysts of the duodenum in a 44-yr-old man complicated by duodenal obstruction and relapsing pancreatitis is presented. The cystic duodenal lesions were visualized by endoscopic retrograde cholangiopancreatography and for the first time by computed tomography and abdominal sonography. Thus, the diagnosis was made preoperatively. The cysts were excised successfully during a Whipple procedure. Awareness of this rare condition combined with modern x-ray, sonographic, and endoscopic techniques permit accurate preoperative diagnosis.

Adult↗